Medicine Chapter 9 Series CPT Guidelines

 

Hello Reader , In this Article we explain all about Medicine Chapter 9 Series CPT Guidelines 2024 updates in an easy way you can find codes and any updates related to Medicine 90000 Series CPT Guidelines  and the code range of Medicine Chapter 9 Series CPT Guidelines, and also you get modifier details that are used during the coding of Medicine CPT Guidelines . Medicine Chapter CPT Guidelines cpt code range start from 90281-99607. There are many modifiers used in Medicine Chapter CPT Guidelines 2024 , which are explained in this article in a very easy way with appropriate examples.

 

1. We can code E/M codes with medicine codes with modifier 25.

 

Immunoglobulin, serum or Recombinant Product

• Code 90281 – 90399 describe anti- infective immunization derived from human blood or recombinant immune globulin products created in a laboratory.
• Don’t report modifier 51 if these services and performed with another procedure.
• The administration of these product must be reported in addition to the product, as appropriate.
• Code 96365 – 96368 , 96369 , 96370, 96371, 96372, 96374, 96375 are the codes reported for administration of immune globulin.

 

Immunization Topic 

 

• The immunization codes are 90460 – 90474. Report codes codes 90460 – 90461 only if the provider counsels the patient, family face – to – face during the administration of the vaccine/ toxoid to a child younger than 18 yrs of age.

 

• Administration code 90460 – 90461 are reported for vaccines with multiple components (combination vaccine) in which you report 90460 for the first component and the additional components in that vaccine you report 90461.

 

• Report codes 90471 -90474 if no counselling is provided for a child less than 18 yrs of age and for the administration of vaccine/ toxoids to patient over 18 yrs of age.

 

• These administration codes are not reported by each vaccine, but reported by how each vaccination is given intramuscular, orally, subcutaneous etc.

 

Important: Don’t report Modifier 51 with these services.

 

If a significant, separately identifiable E/M services is provided at the same encounter, the appropriated.

 

ESRD Topic 

 

ESRD is a procedure that helps your blood get filtered by a machine that works like an artificial kidney.

• Hemodialysis 
• Peritoneal dialysis
• Hemofiltration
• CRRT

Medicine Chapter 9 Series CPT Guidelines

Hemodialysis 

 

• Code 90935, 90937 are reported to describe the hemodialysis procedure with all E/M services related to the patients Renal diseases on the day of the hemodialysis procedure .
• Code 90935, 90937 codes are used for inpatient ESRD and non ESRD or for outpatient non – ESRD.
• Dialysis services code 90935 is reported if only one evaluation of the patient is required related to that hemoglobin procedure.
• Code 90937 is reported when patient re-evaluation is required during a hemodialysis procedure.

 

Note: Use modifier 25 with E/M codes including new and established patient.

 

Miscellaneous Dialysis procedures

 

• Codes 90945, 90947 describe procedures other than hemodialysis (e.g peritoneal dialysis, hemofiltration and continuous renal replacement therapies) and all E/M services related to the patients Renal diseases on the day of the procedure code.

 

• 90945 is reported if only one evaluation of the patient is required related to that procedure. Code 90947 is reported when patient re-evaluation is required during a procedure use modifier 25 with E,/M codes including office or other new Patient.

 

These injection and infusions are broadly classified into two types:

• Therapeutic, prophylactic, diagnostic 
• Chemotherapy 

 

Hydration

whenever you going to hospital with some dehydration doctor will gives electrolyte/ fluids through Intravenous route that will hydrated more.

• 96360 : IV infusion, hydration, initial 31 min to 1 hour.
• +96361 : each additional hour list separately in addition to code for primary procedure.

Infusion CPT Guidelines ( Nacl + Drug) 

 

In medicine, infusion therapy deals with all aspects of fluid and medication infusion, via intravenous or subcutaneous application. A special infusion pump can be used for this purpose.

 

• 96365 : initial intravenous (IV) infusion for therapy, prophylaxis, or diagnosis that lasts up to one hour. 
• +96366: each additional hour (list separately in addition to code for the primary procedure).
• +96367 : additional hour (list separately in addition to code for primary procedure).
• +96368 : concurrent Infusion (list separately).

 

IV Push CPT Guidelines

Intravenous push (IV push) is a process of introducing a medication or fluid substance directly into the bloodstream via the venous system.

 When the medication is administered directly into the bloodstream, it immediately enters the circulatory system and travels to a site of action.

• 96374 : IV Push, single or initial substance / drug less than 16 min.
• +96375 : each additional sequential IV Push of a new drug.
• 96376 : each additional sequential IV Push of the same drug.

 

Intramuscular injection 

• 96372 : Therapeutic, prophylactic or diagnostic injection (specify substance or drug) ; subcutaneous or intramuscular.

 

Modifier 59 

When infusions or injection have been provided in: 

• Two different sites 
• Two different visits 
• Two different route of administration 

 

Port flush 

• 96523 : For irrigation of implanted venous access device.

• Code 36593 for declotting a catheter or port.

 

Psychotherapy CPT Guidelines

 

Psychotherapy is a type of treatment that can help individuals experiencing a wide array of mental health conditions and emotional challenges. Psychotherapy can help not only alleviate symptoms, but also, certain types of psychotherapies can help identify the psychological root causes of one’s condition so a person can function better and have enhanced emotional well-being and healing.

In psychotherapy topic check time given in scenario: 

• 90832 and 90833 : 16 – 37 min
• 90834 and 90836 : 38 – 52 min
• 90837 and 90838 : 53 or more minutes 

 

Note : Don’t report psychotherapy of less than 16 minutes duration.

 

Psychotherapy for crisis 

 

Psychotherapy for crisis is a brief, solution-focused treatment for patients in urgent need of care. It involves:  

Assessment: A mental status exam and history of the crisis state 

Treatment: Psychotherapy, mobilization of resources, and psychotherapeutic interventions  

Goal setting: Identifying behavioral goals and anticipating challenges 

Follow-up: A post-crisis evaluation to assess treatment gains and potential problems 

 

90839 – first 30 – 74 minutes of psychotherapy for crisis on a given date . It should be used only once per date even if time spent by the physician or other healthcare professional is not continuous on that date psychotherapy for crisis of less than 30 min total duration on a given date should be reported with 90832 or 90833 (when provided with E/M services).

 

Code 90840 is used to report additional blocks of time, of up to 30 min , each beyond the first 74 min.

• 90839 : psychotherapy for crisis; first 60 min (30 – 74 min) .
• 90840 : each additional 30 min (list separately in addition to code for primary services.
• Use modifier 26 with cardiac catherization codes.
• Don’t use main branch modifier (LM , LAD / LD ; RC , RI) with add on code of branch 92921, 92925 , 92929, 92934, 92938.
• Don’t use TC or 26 modifier with echocardiography codes 93312 – 93315.
• Don’t use any modifier like 26 or TC with cardiography code 93000 – 93042) for TC and professional component separate codes given.

 

For allergy testing topic 

Check Two points 

1. If doctor is giving injection only , not preparing it then we have to code 95115 and 95117 depend on number of injection given.
2. If preparation and injection given then we have to code 95120 – 95134.

Depends on number of injection, number of insect venom.

 

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Pathology & Laboratory Series Questions CPT :- https://medicopediaa.com/pathology-laboratory-series-questions-cpt/

For Medical Coding Modifiers : https://medicopediaa.com/list-of-modifiers-used-in-cpt/

CPT Guidlines Anesthsia : https://medicopediaa.com/anesthesia-cpt-guidelines/

In this Article We Cover important guidelines of Medicine Chapter CPT Guidelines

Medicine CPT Coding Guidelines , 9 Series coding guidelines , Coding Guidelines Medicine , 90000 Series cpt guidelines.

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